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Resting nailfold capillary blood flow in primary open-angle glaucoma.

Clara C Cousins1, Jonathan C Chou1, Scott H Greenstein1

  • 1Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.

The British Journal of Ophthalmology
|April 28, 2018
PubMed
Summary
This summary is machine-generated.

Reduced blood flow in nailfold capillaries is linked to primary open-angle glaucoma (POAG). This finding holds true even when accounting for factors like blood pressure, pulse, and intraocular pressure (IOP).

Keywords:
blood flowcapillariesnailfold video capillaroscopyprimary open-angle glaucoma

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Area of Science:

  • Ophthalmology
  • Cardiovascular Physiology
  • Microcirculation Research

Background:

  • Primary open-angle glaucoma (POAG) is associated with altered hemodynamics in ocular capillaries.
  • Abnormal non-ocular blood flow may also contribute to POAG.
  • Nailfold capillaries offer an accessible window into microvascular function, unaffected by intraocular pressure (IOP).

Purpose of the Study:

  • To investigate the relationship between resting nailfold capillary blood flow and primary open-angle glaucoma (POAG).
  • To determine if reduced nailfold capillary blood flow is an independent factor in POAG.
  • To assess the influence of IOP and beta-blocker use on this relationship.

Main Methods:

  • Video capillaroscopy was used to measure resting nailfold capillary blood flow in 67 POAG patients and 63 controls.
  • Blood flow was quantified by tracking blood column voids, measuring vessel diameter, and calculating flow rates.
  • Multiple logistic regression analysis was employed to assess the association between nailfold blood flow and POAG, with adjustments for covariates.

Main Results:

  • POAG cases exhibited significantly lower mean nailfold capillary blood flow (26.8±17.6 pL/s) compared to controls (50.1±24.2 pL/s) (p<0.0001).
  • Each pL/s increase in resting nailfold blood flow was associated with a 6% reduction in the odds of POAG (p<0.0001), independent of blood pressure, pulse, and IOP.
  • Similar associations were observed in subgroups stratified by maximum IOP and topical beta-blocker use.

Conclusions:

  • Reduced resting nailfold capillary blood flow is a characteristic finding in primary open-angle glaucoma (POAG).
  • This microcirculatory alteration is present independently of other clinical factors like blood pressure, pulse, and intraocular pressure (IOP).
  • Nailfold capillaroscopy may serve as a valuable tool for assessing systemic vascular contributions to POAG.